Response-dependence theses are usually formulated in terms of a priori true biconditionals of roughly the form ‘something, x, falls under the concept ‘F’ ↔ x would elicit response R from subjects S under conditions C’. Such formulations are vulnerable to conditional fallacy problems; counterexamples threaten whenever the C-conditions’ coming to obtain might alter the object with respect to F. Crispin Wright has suggested that such problems can be avoided by placing the C-conditions in a proviso. This ensures that any changes (...) triggered by the C-conditions’ coming to obtain will be irrelevant to the truth of the biconditional. I argue that this move leaves the equations vulnerable to counterexamples of a slightly different kind: Cases where the change is triggered, not by the C-conditions’ coming to obtain, but by the response. I consider two ways to resist these counterexamples, and argue that both are insufficient. The upshot is a challenge that must be met if provisoed biconditionals are to serve their purpose. (shrink)

Response-dependence theses are usually formulated in terms of a priori true biconditionals of roughly the form 'something, x, falls under the concept 'F' ↔ x would elicit response R from subjects S under conditions C'. Such formulations are vulnerable to conditional fallacy problems; counterexamples threaten whenever the C-conditions' coming to obtain might alter the object with respect to F. Crispin Wright has suggested that such problems can be avoided by placing the C-conditions in a proviso. This ensures that any changes (...) triggered by the C-conditions' coming to obtain will be irrelevant to the truth of the biconditional. I argue that this move leaves the equations vulnerable to counterexamples of a slightly different kind: Cases where the change is triggered, not by the C-conditions' coming to obtain, but by the response. I consider two ways to resist these counterexamples, and argue that both are insufficient. The upshot is a challenge that must be met if provisoed biconditionals are to serve their purpose. (shrink)

According to Nozick’s tracking theory of knowledge, an agent a knows that p just in case her belief that p is true and also satisfies the two tracking conditionals that had p been false, she would not have believed that p , and had p been true under slightly different circumstances, she would still have believed that p . In this paper I wish to highlight an interesting but generally ignored feature of this theory: namely that it is reminiscent of (...) a dispositional account of knowledge: it invites us to think of knowledge as a manifestation of a cognitive disposition to form true beliefs. Indeed, given a general account of dispositions in terms of subjunctive conditionals, the two tracking conditionals are satisfied just in case the belief in question results from some cognitive disposition to form true beliefs. Recently, such a conditional account of dispositions has, however, been criticised for its vulnerability to so-called ‘masked’, ‘mimicked’ and ‘finkish’ counterexamples. I show how the classical counterexamples to Nozick’s theory divide smoothly into four corresponding categories of counterexamples from epistemic masking, mimicking and finkishness. This provides strong evidence for the thesis that satisfaction of the two tracking conditionals is symptomatic of knowledge and that knowledge is instead constituted by a dispositional capability to form true beliefs. The attempt to capture such a cognitive, dispositional capability in terms of the tracking conditionals, although providing a good approximation in a wide variety of cases, still comes apart from the real thing whenever the epistemic layout is characterised by masking-, mimicking- and finkish mechanisms. In the last part of the paper I explore the prospect of improving the tracking theory in the light of these findings. (shrink)

We know things that entail things we apparently cannot come to know. This is a problem for those of us who trust that knowledge is closed under entailment. In the paper I discuss the solutions to this problem offered by epistemic disjunctivism and contextualism. The contention is that neither of these theories has the resources to deal satisfactory with the problem.

In The Philosophical Quarterly, 48 , Alexander Bird raises an objection against the conditional analysis of dispositions: where an ‘antidote’ is present all the supposed conditions for manifestation of a disposition are fulfilled but the manifestation does not occur. But Bird’s argument suffers from equivocation. If we spell out properly whether the disposition's conditions are to include the presence of the antidote or not, the apparent counter‐examples disappear. So his examples do not undermine the conditional analysis of dispositions; they show (...) merely that we need to be careful about describing the examples consistently. (shrink)

Background While it is generally acknowledged that self-prescribing among physicians poses some risk, research finds such behaviour to be common and in certain cases accepted by the medical community. Largely absent from the literature is knowledge about other activities doctors perform for their own medical care or for the informal treatment of family and friends. This study examined the variety, frequency and association of behaviours doctors report providing informally. Informal care included prescriptions, as well as any other type of personal (...) medical treatment (eg, monitoring chronic or serious conditions). Method A survey was sent to 2500 randomly-selected physicians in Colorado, 600 individuals returned questionnaires with usable data. The authors hypothesised: (1) physicians would prescribe the same types of treatment at home as they prescribed professionally; and (2) physicians who informally prescribed addictive medications would be more likely to engage in other types of informal medical care. Results Physicians who wrote prescriptions for antibiotics, psychotropics and opioids at work were more likely to prescribe these medications at home. Those prescribing addictive drugs outside of the office treated more serious illnesses in emergency situations, more chronic conditions and more major medical/surgical conditions informally than did those not routinely prescribing addictive medications. Physicians reported a variety of informal care behaviour and high frequency of informal care to family and friends. Discussion The frequency and variety of informal care reported in this study strongly argues for profession-wide discussion about ethical and guideline considerations for such behaviour. These areas are discussed in the paper. (shrink)

It is argued that reconstructions of the so-called ‘Master Argument’ of Dideros Cronos to the effect that possibility should be understood as present or future truth, essentially relies on two axioms: i) that every true proposition concerning the past is necessary, and ii) that it follows necessarily from a proposition being true that it always has been the case that it would be true. It is furthermore argued that these two axioms are inconsistent in the sense that any tense/modal semantics (...) which incorporates both collapses either modally (fails to distinguish between truth simpliciter and modalised truth) or temporally (fails to offer a plausible semantical account for propositions about the future). This finding is, furthermore, taken as indicator for the more generel claim that there are principled difficulties involved in construing semantics for combined tense/modal logical systems. (shrink)

We know things that entail things we apparently cannot come to know. This is a problem for those of us who trust that knowledge is closed under entailment. In the paper I discuss the solutions to this problem offered by epistemic disjunctivism and contextualism. The contention is that neither of these theories has the resources to deal satisfactory with the problem.

Colin McGinn has argued that consciousness is a nonspatial phenomenon. McGinn’s arguments for the nonspatiality of consciousness are presented and then criticized. It is concluded that consciousness may be as spatial as electric charge and different kinds of abilities.

In my 'Dispositions and Antidotes', The Philosophical Quarterly, 48 (1998), I raise an objection to the conditional analysis of dispositions, both in its simple formulation and in a more sophisticated version due to David Lewis, The Philosophical Quarterly, 47 (1997). The objection suggests that a disposition may be continuously present and the appropriate stimulus occur without the manifestation occurring, because some outside influence, an antidote, interferes. Gundersen in The Philosophical Quarterly, 50 (2000), argues that my objection rests on an (...) equivocation about which object possesses the disposition and more particularly on an equivocation about the context in which the events referred to take place, and that when the equivocation is resolved the counter-example disappears. I respond by showing that the counter-example does remain if we take contextual and mereological issues into account, and I conclude by remarking that the difference with Lewisdepends on whether certain features are seen as significant for the semanticsand metaphysics of dispositions or as merely characteristic of the pragmaticsof common usage. (shrink)

In this paper I will first consider Bird's cases against the conditional analysis of dispositions and defend them from Gundersen's objection. This does not mean that I believe that Bird's cases are successful. To the contrary, I take it that we can save the conditional analysis from Bird's cases by taking Lewis's two-step approach to dispositions. However, I will go on to argue that if Bird's cases are supplemented with the assumption that dispositions are intrinsic matter, they are able (...) to do what they are intended to do. (shrink)

Background: As genetics technology proceeds, practices of genetic testing have become more heterogeneous: many different types of tests are finding their way to the public in different settings and for a variety of purposes. This diversification is relevant to the discourse on ethical, legal and societal issues (ELSI) surrounding genetic testing, which must evolve to encompass these differences. One important development is the rise of personal genome testing on the basis of genetic profiling: the testing of multiple genetic variants simultaneously (...) for the prediction of common multifactorial diseases. Currently, an increasing number of companies are offering personal genome tests directly to consumers and are spurring ELSI-discussions, which stand in need of clarification. This paper presents a systematic approach to the ELSI-evaluation of personal genome testing for multifactorial diseases along the lines of its test characteristics.DiscussionThis paper addresses four test characteristics of personal genome testing: its being a non-targeted type of testing, its high analytical validity, low clinical validity and problematic clinical utility. These characteristics raise their own specific ELSI, for example: non-targeted genetic profiling poses serious problems for information provision and informed consent. Questions about the quantity and quality of the necessary information, as well as about moral responsibilities with regard to the provision of information are therefore becoming central themes within ELSI-discussions of personal genome testing. Further, the current low level of clinical validity of genetic profiles raises questions concerning societal risks and regulatory requirements, whereas simultaneously it causes traditional ELSI-issues of clinical genetics, such as psychological and health risks, discrimination, and stigmatization, to lose part of their relevance. Also, classic notions of clinical utility are challenged by the newer notion of 'personal utility.'SummaryConsideration of test characteristics is essential to any valuable discourse on the ELSI of personal genome testing for multifactorial diseases. Four key characteristics of the test - targeted/non-targeted testing, analytical validity, clinical validity and clinical utility - together determine the applicability and the relevance of ELSI to specific tests. The paper identifies and discusses four areas of interest for the ELSI-debate on personal genome testing: informational problems, risks, regulatory issues, and the notion of personal utility. (shrink)

Broad genome-wide testing is increasingly finding its way to the public through the online direct-to-consumer marketing of so-called personal genome tests. Personal genome tests estimate genetic susceptibilities to multiple diseases and other phenotypic traits simultaneously. Providers commonly make use of Terms of Service agreements rather than informed consent procedures. However, to protect consumers from the potential physical, psychological and social harms associated with personal genome testing and to promote autonomous decision-making with regard to the testing offer, we argue that current (...) practices of information provision are insufficient and that there is a place – and a need – for informed consent in personal genome testing, also when it is offered commercially. The increasing quantity, complexity and diversity of most testing offers, however, pose challenges for information provision and informed consent. Both specific and generic models for informed consent fail to meet its moral aims when applied to personal genome testing. Consumers should be enabled to know the limitations, risks and implications of personal genome testing and should be given control over the genetic information they do or do not wish to obtain. We present the outline of a new model for informed consent which can meet both the norm of providing sufficient information and the norm of providing understandable information. The model can be used for personal genome testing, but will also be applicable to other, future forms of broad genetic testing or screening in commercial and clinical settings. (shrink)

The advent of new genetic and genomic technologies may cause friction with the principle of respect for autonomy and demands a rethinking of traditional interpretations of the concept of informed consent. Technologies such as whole-genome sequencing and micro-array based analysis enable genome-wide testing for many heterogeneous abnormalities and predispositions simultaneously. This may challenge the feasibility of providing adequate pre-test information and achieving autonomous decision-making. At a symposium held at the 11th World Congress of Bioethics in June 2012 (Rotterdam), organized by (...) the International Association of Bioethics, these challenges were presented for three different areas in which these so-called ‘new genetics’ technologies are increasingly being applied: newborn screening, prenatal screening strategies and commercial personal genome testing. In this article, we build upon the existing ethical framework for a responsible set-up of testing and screening offers and reinterpret some of its criteria in the light of the new genetics. As we will argue, the scope of a responsible testing or screening offer should align with the purpose(s) of testing and with the principle of respect for autonomy for all stakeholders involved, including (future) children. Informed consent is a prerequisite but requires a new approach. We present preliminary and general directions for an individualized or differentiated set-up of the testing offer and for the informed consent process. With this article we wish to contribute to the formation of new ideas on how to tackle the issues of autonomy and informed consent for (public) healthcare and direct-to-consumer applications of the new genetics. (shrink)

We review evidence regarding Tomasello et al.'s proposal that individuals with autism understand intentions but fail socially because of a lack of motivation to share intentions. We argue that they are often motivated to understand others but fail because they lack the perceptual integration skills that are needed to apply their basically intact theory of mind skills in complex social situations.

Throughout the longstanding debate on privacy, the concept has been framed in various ways. Most often it has been discussed as an area within which individuals rightfully may expect to be left alone and in terms of certain data that they should be entitled to control. The sphere in which individuals should be granted freedom from intrusion has typically been equated with the indisputably private domestic sphere. Privacy claims in the semi-public area of work have not been sufficiently investigated. In (...) this article, the case is made that employees have reasonable expectations on privacy at work. Firstly, in a descriptive analysis, employees’ need for workspace privacy is spelt out. Secondly, a normative analysis explicates the reasons why privacy should be protected. The main thrust is to provide a more inclusive privacy concept and hence, a more adequate basis for privacy protection legislation and codes in the area of work. Contrary to prevailing workplace privacy protection, employees’ need for local privacy should be accommodated as well as informational privacy. (shrink)

The starting point of this article is that employees’ chances of securing reasonable expectations of privacy at work must be better protected. A dependency asymmetry between employer and job-applicant implies that prospective employees are in a disadvantaged position vis à vis the employer regarding the chances of defending their reasonable interests. Since an increased usage of work related surveillance will, to a larger extent, require of job-applicants that they negotiate their privacy interests in employment contracting, it is important to consider (...) means of strengthening employees’ negotiating power. This article emphasizes the importance of contextualizing consent for contractual agreements to be ethically acceptable. (shrink)

An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely to become involved in the caring process and (...) informal caregivers may have to assist kin-persons with advanced care needs by means of sophisticated technology. This paper investigates some of the ethical implications of a near-future shift from institutional care to technology-assisted home care and the subsequent impact on the care recipient and formal- and informal care providers. (shrink)

In this paper I introduce a theoretical framework on care developed by the Norwegian nurse and philosopher Kari Martinsen, and I argue that this approach has relevance not only within nursing, but also within clinical medicine. I try to substantiate this claim by analysing some of the key concepts in this approach, and I illustrate the potential clinical relevance of this approach by applying it in relation to two care scenarios. Finally, I discuss some of the concerns that have been (...) raised in relation to the aim of highlighting care in medicine. (shrink)